A Clinical Study of Displaced Clavicle Fractures Treated with Anatomically Precontoured Locking Compression Plate (original) (raw)
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Treatment of Displaced Middle Third Clavicle Fracture with Precontoured Clavicular Locking Plate
Scholars Journal of Applied Medical Sciences, 2020
Original Research Article Background: A clavicle fracture, also known as a broken collarbone, is a bone fracture of the clavicle. Symptoms typically include pain at the site of the break and a decreased ability to move the affected arm. It accounts about 2.6% of all fractures in adult and 44% in shoulder region. Midshaft clavicle fractures accounts about 81% of total clavicle fractures. Aims & Objectives: The study aimed to evaluate the outcome of surgical management of displaced midshaft clavicle fracture with precontoured locking plate. Materials & Methods: A prospective study was conducted in four (4) selected hospitals like
Surgical treatment of middle third fracture clavicle in adults by pre-contoured locked plate
2021
Background: The clavicle is one of the bones that are most commonly fractured in the body. In adults, clavicle fractures represent 5–10 % of all fractures and 35 % of shoulder girdle fractures. Although most clavicular fractures may be treated nonoperatively, there is still a debate about the best therapy option for displaced mid-shaft clavicle fracture. Aim of the Study: To investigate the results of surgical fixation of displaced middle-third fracture clavicle by the anatomical pre-contoured locked plate in young adults. Materials and methods: This research involved 20 adult patients with a recent middle-third clavicle fracture. Results were assessed after 1 year according to the Disabilities of the Arm, Shoulder, Hand score (DASH). Results: The average age of the patients was 37 years old (25 - 52 years), all of them were males, All the fractures achieved union at 9 weeks (8-14 weeks ) postoperatively with no cases of implant failure, The average DASH score became15.3, 18 patient...
Evaluation of Outcome of Type 2 Clavicular Fractures with Pre-Contoured Locking Compression Plates
2019
Background: Clavicular fracture is a common traumatic condition encountered around shoulder region in adult population, while mid-shaft fractures (Robinson’s type 2) are found to be a most common variety. Management trends have changed in recent years from conservative to surgery, considering the higher rates of malunion, nonunion and poorer functional outcomes when managed non-operatively. An open reduction and internal fixation with precontoured locking compression plates has been a backbone of treatment of these fractures for several years with the aim of anatomical reduction, stable fixation and early rehabilitation of affected shoulder. Objective: To evaluate the outcome of Robinson type 2 clavicular fractures managed surgically with precontoured locking compression plates. Methods: Prospective study of 100 adult patients with Robinson type 2 clavicular fractures managed surgically with precontoured locking compression plates from January 2017 to November 2019 at the department...
Precontoured Locking Plate Fixation for Displaced Lateral Clavicle Fractures
Orthopedics, 2013
Displaced fractures of the lateral end of the clavicle are associated with an increased risk of nonunion with conservative treatment; therefore, operative treatment is recommended. Various operative treatments have been suggested, but no consensus exists regarding a gold standard for the surgical treatment of this type of fracture. The purpose of this study was to evaluate clinical and radiological outcomes using a precontoured locking compressive distal clavicular plate for Neer type II distal clavicle fractures. Thirty-five patients with Neer type II distal clavicle fractures underwent surgery between March 2009 and January 2012. All patients were evaluated for function using the Constant-Murley Shoulder Outcome Score and University of California, Los Angeles shoulder rating scale, active shoulder range of motion, time to bone union, and coracoclavicular distance. Mean follow-up was 24.2 months (range, 12–35 months). No significant difference existed between the injured and contra...
National Journal of Clinical Orthopaedics
Background: The aim of this study to assess the functional outcome in clavicle fracture treated with anatomical locking compression clavicle plate conducted at Dhiraj Hospital, Vadodara Gujarat. The patient history and examination findings were recorded and then radiological investigation were ordered to confirm the diagnosis. The findings and plan of management were discussed with operating consultant and recorded in 2 separate profoma. Any change in opinion between the consultant were noted in the profoma. Result: The result evaluated by DASH SCORE in our study. Out of 34 patients 20(58.9%) patients had good result, 12(35.3%) had excellent result and 2(5.8%) had poor result Conclusion: We conclude that Anatomical Locking Clavicle Plate is preferred for the treatment of displaced or non-united clavicle fractures with better functional outcome and faster recovery compared to other modes of treatment.
Background: Fractures of the clavicle account for 2.6% to 4% of all fractures. Operative management of displaced fractures of the midshaft clavicle is preferred due to better outcomes. Various plates are used for fixation of these fractures, which include reconstruction plates, dynamic compression plates, and precontoured locking plates. Very few studies have documented whether the proposed benefits of precontoured plates are realized in a clinical setting. In this study, we compared the outcomes and complications of displaced midshaft clavicular fractures fixed using precontoured and reconstruction plates.
Outcome of distal end clavicle fractures treated with locking plates
Chinese Journal of Traumatology, 2017
Purpose: Fractures of the lateral end of the clavicle are relatively uncommon. These fractures are unstable due to the various deforming forces which act on the fragments as well as the small distal fracture fragment. At most times the deforming forces are not taken into consideration, and the fracture is not fixed securely. In this study, we assessed a fixation technique using the precontoured locking plates to find out whether it provided a stable fixation with good functional outcome. Methods: Totally, 32 patients with lateral end clavicle fracture (Neer's Type II) were included in the study. After the informed consent and preoperative investigations were obtained, open reduction and internal fixation was done using a 3.5 mm precontoured superior locking plate with lateral extension under general anesthesia. Postoperative X-rays were done on day 1 and every 6 weeks after operation, until radiological union was achieved. The postoperative pain was assessed using Visual Analogue Scale (VAS) on postoperative days 1, 2 and 10. Postoperatively arm pouch sling was given for 2 weeks followed by active mobilization. Patients were asked to do their daily routine work and avoid lifting heavy weights. The functional outcome was assessed at the end of 2nd and 6th months with the help of Disabilities of the Arm, Shoulder and Hand (DASH) scoring. Results: There were no intraoperative complications in the procedure. The mean VAS score on postoperative day 1 was found to be 5 which decreased to 3 on day 2 and 0 on day 10. The mean DASH score was calculated as 11.63 at the end of postoperative month 2 and then 4.6 at the end of month 6. There was one case of malunion in whom the overhead abduction was restricted but was not painful and was managed conservatively. Conclusion: The precontoured locking plates with lateral extension may be a good method to fix the fractures of the lateral end clavicle, which provide a stable fixation with good functional outcome with very few instances of stiffness and decreased range of motion of the shoulder with the hook plates and failure of fixation in screw and K-wire fixations. It may well be the answer to the fixation questions of the lateral clavicle fractures, although larger comparative studies between the surgical treatment methods are required to confirm the same.
2018
Background: Clavicle fracture is a common traumatic injury around shoulder girdle due to its subcutaneous position. Open reduction and internal fixation can be achieved with intramedullary devices or plate fixation. Aim: To study the functional outcome of surgically treated acute displaced middle one third clavicle shaft fractures with plate and screws. Material and Methods: In this study 30 patients with middle one third clavicle shaft fractures were included who underwent open reduction and internal fixation. In 15 patients anatomically contoured locking compression plate, in 11 patients simple straight locking compression plate, in 3 patients dynamic compression plate and in 1 patient reconstruction plate was used. Results: Average duration for union of clavicle fracture was 12 weeks which includes 2 cases with delayed union. One patient with delayed union resulted in plate breakage which united after replating and bone grafting. Functional outcome after union of surgically treat...
Comparative study of Non-operative versus Operative treatment for middle 1/3 rd clavicle fracture
Background: A fracture of the clavicle has been greatly underrated in respect to pain and disability. Clavicle is the bony link from thorax to shoulder girdle and contributes to movements at shoulder girdle. Clavicle fracture is a common traumatic injury around shoulder girdle due to its subcutaneous position. It is caused by either low-energy or high-energy impact about 69 to 82% of these fractures are in the middle third of bone and less often in the lateral third (12% to 15%) and medial third (5% to 8%). Prompt fixation of these clavicle fractures permits increased patient comfort and early shoulder mobility. The proponents of early fixation of fresh clavicular fractures to prevent complications like malunion and nonunion emphasize the value of accurate reduction and rigid fixation in affording quick pain relief and promoting early functional recovery. Material and methods: Thirty patients were taken into the study and were divided into operative (O) and conservative (C) category. Approval from ethical committee was taken with written informed consent by the patient. The outcome was evaluated clinically radiologically for union, complications, cosmesis and functional scoring by Constant and Murley score. Observation and Result: Out of 30 patients, 18 were treated conservatively, Among them good anatomical results were found in 13 patients (72.22%), poor results were found in 5 patients (27.78%). 12 patients were treated surgically, Among them good anatomical results were found in 11 patients (91.67%) and poor were found in 1 patient (8.33%).patients were treated conservatively and had excellent functional outcome (27.78%) in 5 patients, good functional outcome (55.56%) in 10 patients, and fair functional outcome (16.67%) in 3 patients. 12 patients were treated surgically with precontoured clavicle plate and had excellent functional outcome (91.67%) in 11 patients and fair functional outcome (8.33%) in 1patients. Out of 30 patients, 4 patients (22.22%) of displaced middle third clavicle fractures which were treated conservatively had developed malunion, 1 patient (5.56%) had developed delayed union and no non-union was reported. In 12 patients which were treated surgically with precontoured plate, 1 patient (8.33%) was reported with hardware irritation and 1 patient (8.33%) was reported with implant failure. The average union time is longer in conservatively treated patients (12.33) weeks as compared to operative group i.e; (8.67) weeks. Conclusion: primary open reduction and internal fixation with precontoured clavicle plate for displaced, comminuted middle third clavicle fractures provides a more rigid fixation and allows early mobilization higher functional outcome compared with conservative treatment which require longer periods of immobilization till fracture union. Simple, undisplaced fractures can be treated with conservative treatment which gives good results in terms of functional and anatomical aspects but when this method is used for displaced, comminuted fractures it gives complications such as malunion and non-union.
Zagazig University Medical Journal, 2019
Introduction: Fracture clavicle used to be treated conservatively. But, risk of mal-union and shoulder dysfunction has raised many concerns regarding this way of treatment. Operative treatment for clavicle fracture gained popularity recently for displaced fracture clavicle. So, in our study we compared between the two methods of treatment. Patients and methods: We conducted a prospective study for all adult patient presented to our hospital with unstable fracture clavicle from August 2016 to September 2017. Patients were divided in two groups A and B, with exclusion of poly-trauma patients. Group A treated conservatively and group B treated by open reduction and internal fixation with plate and screws on the superior surface of the clavicle. The patients were followed up and assessed by constant shoulder score. Results: The study included 20 patients in two group 10 patient for each group. The demographic data in both groups showed no significant differences. Follow up was 6.2 and 7.3 months in both groups respectively. Union occurred in 5.8 and 5.3 months in both groups respectively. The difference was insignificant for follow up and union; p value> 0.05. Functional outcome was excellent in 8 and good in 2 in group A, and excellent in 6, good in 4 in group B. This difference was found to be significant, p value ˂ 0.05. Conclusion: From our study and supported by others we recommend that conservative treatment should be the first choice for most patients and operative fixation to be reserved for selected cases.